Cancer. It’s a word people fear and a diagnosis that often inspires fatalism. However, as World Cancer Day raises awareness about the disease on Wed., Feb. 4, the Louisiana Comprehensive Cancer Control Program (LCCCP) wants people to know there are at least six cancers they can easily avoid or catch early enough to beat.
1. Lung. Don’t smoke. Lung cancer is the most fatal cancer in the world and tobacco accounts for 90 percent of those deaths. That figure includes deaths from cigarettes, cigars and secondhand smoke, which is why businesses, municipalities and more are banning smoking. Even New Orleans, a city with a reputation for vice, has become the first city in the tobacco-friendly South to pass a smoking ban. The scientific evidence presented by LCCCP and other health organizations there, plus compelling testimony from musicians, waiters and others, made a strong case for the ban, even defeating industry attempts to exempt bars and casinos.
As for electronic cigarettes or e-cigs, the long-term studies needed to prove they are safe or help people quit smoking tobacco do not yet exist. And though some say they may be less toxic for current smokers, those studies also all note that e-cigs still have toxicants, are not carcinogenic-free and contain nicotine, which is addictive. The concentrated liquid nicotine refills used for e-cigs are also toxic, with the Centers for Disease Control and Prevention (CDC) noting a dramatic increase in calls to poison control centers from people who have ingested, inhaled or absorbed refills. These refills are marketed with attractive flavors, colors and scents that are particularly appealing to children, resulting in 51 percent of poisoning calls involving children five and under.
In addition, a study done by researchers at the CDC, the Food and Drug Administration and Georgia State University also found during 2011-2013, that the number of youth who had never smoked a cigarette, but had used e-cigs had tripled, while never-smokers who had used e-cigs were nearly twice as likely to intend smoking conventional cigarettes than never-smokers who had never used e-cigs. And, in a study just released in the New England Journal of Medicine, researchers found high levels of formaldehyde in e-cig aerosols, which they estimate could increase the risk of cancer five to 15 times higher than the risk of long-term smoking.
2. Colon. Prevent it by getting screened once you turn 50. The second leading cancer killer in the United States is colorectal. Surprised? More shocking is that it is a very preventable cancer. And now that the Affordable Care Act (ACA) requires coverage for preventive screenings, including colonoscopies, there is no reason for such deaths.
Health experts recommend everyone 50 and over be screened in order to find precancerous polyps, which can be easily removed or so that the cancer can be caught early, treated and cured. That is why the National Colorectal Cancer Roundtable has adopted as its slogan “80% by 2018” with the goal being to get that percentage of people 50 and over screened by that year. LCCCP is following that example and working to help form a Louisiana Colorectal Cancer Roundtable to improve statistics in the state, which has the fifth highest colorectal cancer death rate in the U.S. and even higher rates among its black male and Cajun populations.
The most well-known screening test, colonoscopy, is often called the “gold standard,” but public health experts also note “The best test is the one you’re going to get.” Other medical facility tests include fecal or flexible sigmoidoscopy; a double-contrast barium enema; or a CT colonography. At-home stool tests include the FOBT, FIT or Cologuard. Not all colon screening tests have been approved by the U.S. Preventive Services Task Force, so be aware insurance plans may not cover them. If anything unusual is found, a follow-up colonoscopy will likely be required.
Controllable risk factors include a diet high in red or processed meats, lack of physical activity, obesity and the use of tobacco and alcohol. Uncontrollable risk factors include family history of the disease, genetic syndromes (FAP or Lynch syndrome) and related diseases, such as inflammatory bowel disease, Crohn’s disease and ulcerative colitis.
3. Breast. Prevent it by getting screened on a regular basis. Pink ribbons notwithstanding, breast cancer still kills a lot of people (not all of whom are women.) It is the third highest cancer killer across the nation and the most common cause of cancer in women. But like lung and colon cancer, those statistics needn’t be that high.
Regular mammograms starting at 50 are recommended by all the major health organizations, with no more than two years between screenings and most recommending annually. And though some disagree as to whether women should start screening at 40, all agree women need to consider it at that age, with the American Cancer Society, the National Comprehensive Cancer Network and Susan G. Komen recommending women start then, while others such as the CDC and the American Medical Association recommending women 40 to 49 discuss the issue with their doctor.
Lifestyle factors that increase breast cancer risk include childless women or those who had their first after 30, drinking alcohol, being overweight and being inactive.
Women should know that ACA now requires coverage of mammograms and, if they still lack insurance and meet Federal Poverty Guidelines, they can get screened through the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which exists in every state, the District of Columbia, five U.S. territories and in 11 American Indian/Alaska Native tribal organizations.
The Louisiana Breast and Cervical Health Program, is the NBCCEDP program in the state and a sister program to the LCCCP. It offers no-cost breast and cervical cancer screenings and can be reached at 888-599-1073 or at www.lbchp.org.
4. Cervical. Prevent it by having a Pap test on a regular basis and getting the HPV vaccine. The CDC unequivocally states “No woman should ever die from cervical cancer.” Regular Pap tests can detect the cancer early and are covered under ACA. And like breast cancer, cervical cancer screenings are available through the NBCCEDP and through the LBCHP in Louisiana at 888-599-1073 or www.lbchp.org.
Almost every adult in the U.S. will get the human papillomavirus at some point, with the CDC estimating 79 million American are currently infected. Most of the time, it does no harm, but it can cause genital warts and a number of cancers in both men and women, including 99 percent of cervical cancers. The HPV vaccine, one of only two existing cancer vaccines, can prevent all of those diseases and is administered to boys and girls starting at age 11 or 12, when it can generate its best immune response for the future and be administered long before any exposure to the virus.
Older people, including men up to age 21 (or 26, if gay, bisexual or have compromised immune system) and women up to age 26 are also eligible. Most private health insurance plans now cover the HPV vaccine at no out-of-pocket cost because of ACA, while low-income children may be eligible for it through the federal Vaccines for Children Program (www.cdc.gov/vaccines/programs/vfc/index.html).
5. Prostate. Talk to your doctor about screening. Prostate cancer is the most common cancer in men and there are screenings to detect it. However, treatment can sometimes have more serious consequences (bowel and urination issues, impotence) than the disease, which grows slowly and often does no harm. Therefore, health experts now recommend men discuss their situation and risk factors with their doctors starting at 50, and black men, because they are impacted more by the disease, at age 45.
6. Skin. Protect yourself from the sun and don’t tan, indoor or out. Skin cancer is the most common cancer in the United States, especially among white men. And the deadliest kind is melanoma, which is caused by sun exposure. So cover up!
For more information, go to www.lcccp.org.
The Louisiana Comprehensive Cancer Control Program (LCCCP) is one of the CDC-funded Louisiana Cancer Prevention and Control Programs (LCP) housed at the LSU Health Sciences Center School of Public Health. For more information, go to www.louisianacancer.org.